Patient Preferences for Cancer Care Within Hub-and-Spoke Networks: A Discrete Choice Experiment

Area of Science:

• Oncology
• Health Services Research
• Rural Health

Background:

• Hub-and-spoke cancer networks aim to expand specialized care to rural areas.
• Patient preferences for care delivery within these networks are not well understood.

Purpose of the Study:

• To quantify rural patient preferences for cancer care delivery.
• To identify distinct patient preference phenotypes to guide hub-and-spoke network design.

Main Methods:

• A cross-sectional discrete choice experiment surveyed 171 rural patients.
• Evaluated tradeoffs in travel time, provider specialization, visit type, case review, and surgical team experience.
• Latent class analysis identified patient preference phenotypes.

Main Results:

• For surgical care, surgical team experience and surgeon specialization were paramount.
• For non-surgical care, visit type, travel, and provider type were most important.
• Four distinct patient phenotypes emerged: preference for specialist oncologist, direct expert review, in-person visits, or limiting travel.

Conclusions:

• Rural patients exhibit diverse, treatment-specific preferences within cancer networks.
• Eliciting patient preferences can inform specialist deployment, telemedicine, case review, and resource allocation.